[Albrecht von Haller. An illustrious ancestor].

Albrecht von Haller (1708-1777) was one of the most famous and important men of the eighteenth century. His achievements make him comparable with Lessing and Newton. In Blumenbach's opinion he was one of the enlightenment's greatest thinkers in both versatility and depth.

[Surgery school. Tradition-transition-change in paradigm?].

First Schools in Surgery already at the antiquity. During the medieval some slow developments in this regard throughout Europe, especially in France and Italy. In Germany because of the great changes and progresses in the medical sciences foundations of the first surgical schools in Vienna and Berlin.

Acute psychological care by the operating surgeon.

The diagnosis of breast cancer causes severe psychological conflicts. This is because of the sudden need for a mutilating breast operation and because of the threatening confrontation with a potentially lethal disease. The consequence can be a spectrum of physical and mental sequelae, access to which the physician may find difficult.

Morbidity and mortality in 602 patients with acute pancreatitis seen between the years 1980-1994.

The course of a first attack of acute pancreatitis was evaluated in a retrospective study of 602 patients, who were admitted between 01.01.1980 and 30.

Gastrin-releasing peptide and CCK after intraduodenal inhibition of proteases in dogs.

The intraduodenal application of a potent protease inhibitor (camostate, 600 mg) causes a significant increase in basal pancreatic secretion in the manner of a negative-feedback mechanism. The integrated protein secretion during the entire study period was 9.9 +/- 1.

[New trends in biliary surgery].

On the basis of the experience gained in 893 laparoscopic procedures performed on the gallbladder, and with increasing frequency on the bile-ducts, and on the basis of a comprehensive review of the literature from 1992 and 1993 pertaining to this subject, a critical analysis of laparoscopic gallbladder surgery has been accomplished. As substantiated by recent publications, laparoscopic cholecystectomy has achieved wide acceptance in surgical practice. Over the course of the last two years, discussion has focussed on the avoidance of injury caused by Veress needle and trocar puncture and specific pneumoperitoneum-associated complications, as well as the minimisation of overlooked and/or spilled bile-duct calculi and the avoidance of iatrogenic bile-duct injuries.

[The Chang mesocaval side-to-side shunt, an alternative shunt form after previous operations and portal vein thrombosis].

Over the time period from July 01, 1983 to June 01, 1993, 15 patients with portal hypertension and relapsing bleedings from esophageal varicosis were treated with Chang's mesocaval side-to-side shunt at the Department of General Surgery, University Hospital of Göttingen. All patients were pre-operated in the upper abdomen or exhibited thrombosis of the portal vein. While five cases revealed a prehepatic block, ten patients had an intrahepatic block, based on cirrhosis of the liver (Child classification A or B).

[Effect of pancreatic innervation on exocrine secretory performance of the pancreas].

In the present study we examined the influence of extrinsic pancreatic innervation on exocrine pancreatic response to secretin, caerulein, tryptophan and fat, and furthermore the amino acid- and fat-stimulated release of neurotensin and CCK in dogs. Denervation of the pancreas did not alter secretory response to secretin and caerulein, whereas transsection of the extrinsic nerves significantly diminished the protein response to tryptophan and fat. Release of CCK was not altered by pancreatic denervation.

[Closing the resection surface in left pancreatic resection with the surgical stapler].

In the present paper a technique is demonstrated wherein the closure of the pancreatic remnant following left pancreatectomy with absorbable staples was performed. The good results with minimal complications recommend this method.

Treatment of iatrogenic common bile duct injury during laparoscopic cholecystectomy through the laparoscopic insertion of a T-tube stent.

Iatrogenic injury to the common bile duct during laparoscopic cholecystectomy has previously necessitated an immediate laparotomy to alleviate bile leakage. In the course of 171 laparoscopic cholecystectomies performed at our hospital, intraoperative common bile duct injuries occurred in 2 patients. Each case was successfully treated using a laparoscopically placed T-tube, thus avoiding the need for a laparotomy.

Myogenic basis of motility in the pyloric region of human and canine stomachs.

In vitro gastric motility was investigated in 48 human and 16 canine stomachs by measuring the mechanical activity of isolated muscle strips under auxotonic conditions. For a precise regional differentiation, we recorded the mechanical activity of longitudinal and circular strips from fundus, corpus and antrum, as well as from circular preparations of the inner and outer layer of the pyloric sphincter and from the duodenum. The analysis showed that the anatomical division of the stomach into three distinct regions resulted physiologically in different patterns of contraction in vitro for each region.

[Pancreatico-pleural fistula. Clinical aspects and therapy of a rare disease entity].

We report of 2 patients with pancreatic-pleural fistulas in chronic pancreatitis. In both cases abdominal symptoms were missed, the primary clinical manifestation was a recurrent pleural effusion with a high content of amylase. Endoscopic retrograde cholangiopancreaticography is necessary for a precise evaluation of the fistula and is indispensable to the surgical therapy.

Cystic neoplasms of the pancreas: a clinical and radiological study of eight cases.

Four patients with benign serous cystadenoma, one with mucinous cystadenoma, and three with mucinous cystadenocarcinoma treated in the university hospital of Göttingen between 1985 and 1988 were investigated. The main initial symptoms of these cystic tumors were abdominal pain (7/8), weight loss (3/8), maldigestion (3/8), and palpable abdominal mass (3/8), while laboratory investigations revealed nonspecific alterations (elevated ESR, mild hypochromic anemia). CA 19-9 was elevated in two patients, one of whom had cystadenocarcinoma; CEA also was elevated in this patient only.

[Surgical therapy of chronic pancreatitis].

From a series of 411 surgical operations in chronic pancreatitis patients, 142 were analyzed with respect to indication, early and late mortality, and results. Average follow-up time was 10 years. Resective procedures were used in 51 patients and drainage in 24.

The perfused porcine pancreas as a model for testing organ protective solutions.

The present study was designed to establish an in vitro perfused porcine pancreas preparation as a model for testing the effect of organ protective solutions on stimulated pancreatic endocrine and exocrine secretion. The pancreas was prepared and perfused for 10 min with Euro Collins solution, thereafter it was stored in the cold (4 degrees C) for various times. After 3-h and 6-h ischemia pancreatic insulin release in response to glucose was not significantly affected.

[Staging in non-Hodgkin's lymphomas].

In the period from 1970 to 1986, 46 patients with non-Hodgkin's lymphoma were laparotomized and splenectomized at the Surgery Division, University of Göttingen. The operation was frequently carried out in advanced or generalized stages with a therapeutic indication and served for purely diagnostic purposes in only a proportion of the cases. The Kiel classification was chosen for the histology.

[Staging in Hodgkin's lymphoma. Exploratory laparotomy with splenectomy].

In the present paper, 66 Studies on exploratory laparotomy with splenectomy in Hodgkin's lymphoma from Western Europe and the USA are presented in tables. This statistical compilation on 7183 laparotomies shows that the spleen was involved in 39.9% (2685 out of 6900 cases investigated), the liver in only 7.